OPIOID EPIDEMIC- Using Opioid Settlement Money to Solve the Opioid Epidemic

With settlements being reached in lawsuits by state attorneys general nationwide against the pharmaceutical that produced opioids for their part in feeding the opioid epidemic, local and state governments are working to apply that money into programs to prevent future opioid overdoses and treatment and recovery programs to reduce overdoses and deaths from these dangerous drugs.

Washington State’s share of the settlement money so far is $1.29 billion according to the Washington State Attorney General’s Office.

This money comes at a time when drug overdose deaths have fallen slightly between 2022 and 2023 for most of the country, except for Washington which is among 12 states that have seen an increase in drug deaths, according to the Centers for Disease Control and Prevention (CDC). In fact, Washington and Oregon are among the three worse states for an increase in drug deaths. Washington has seen a 24.85% increase from 2022 to 2023 and Oregon has seen a 22.78% increase.

Earlier this year Representative Rick Larsen’s (D, 2^nd Congressional District) office issued a report, “The Opioid Crisis in Washington’s Second Congressional District and a Comprehensive Solution,” with a plan to battle the opioid epidemic. The report focuses on four pillars to address the opioid crisis, Prevention, Interdiction, Treatment, Recovery:

 

·         Prevention- The report’s goal to prevention is “… to prevent individuals from relying on opioids, instead of implementing stopgaps that simply mitigate the impacts of the crisis.” It lists a variety of programs within the 2^nd Congressional District that work on prevention including the Snohomish County Human Services contract with school districts within in the county that provide Student Support Advocates as well as youth substance use prevention for teachers and counselors. The programs concentrate on youth to try to steer them away from using opioids. The report also lists other programs that use different strategies to reduce dependence on opioids and encourages the development of help to local governments to add other strategies such as helping with mental health and chronic pain.

·         Interdiction- The report lists several federal agencies that are responsible for interdicting drugs. For example, the U.S. Coast Guard patrols our coastal waters to intercept drugs before they land on our shores. The Drug Enforcement Administration (DEA) investigates domestic and international narcotics traffickers. The U.S. Customs and Border Patrol (CBP) intercepts drugs and ports of entry and between ports of entry. In Fiscal Year 2023, CBP seized 27,023 pounds of fentanyl, an 84% increase from 2022. The report notes that more than 90% of CBP fentanyl seizures occur at Land Ports of Entry rather than between ports of entry, with an average of 1,797 pounds of fentanyl seized per day. The report advocated for improved advanced screening technology at ports of entry. The report also noted that local drug task forces have an important role in interdicting drugs before they are sold to drug users. The Snohomish Regional Drug Task Force seized more than 500,000 fentanyl pills and nearly 5,000 grams of fentanyl from January to July 2023. The report advocated for more support and resources for local drug task forces and for local tribal law enforcement.

·         Treatment- The report notes that there are many challenges to treating someone who is addicted to opioids. It notes that people with Opioid Use Disorder (OUD) are physically and psychologically reliant on opioids so that anyone who tries to stop taking opioids suffers severe withdrawal symptoms that can include generalized pain, chills, cramps, diarrhea, restlessness, anxiety, nausea, vomiting, insomnia, and intense cravings. As a result, someone with OUD is susceptible to relapses, disability, and death. It advocates for a “holistic” approach to overcome the challenges and includes normalizing harm reduction, ensuring that there are enough beds for recovery treatment, improving OUD coverage for Medicare and Medicaid, investing in a robust health care workforce, leveraging the justice system with incentives to seek treatment, and meeting patient where they are.

·         Recovery- In conjunction with treatment, someone with OUD also needs support to ensure long-term success in staying off of opioids. Individuals often need help with acquiring housing, employment, education, transportation, or legal services. Currently, support can come from local government and nonprofit organizations. The report also notes that support from family and friends can be especially important.

 

A recent article in The Herald summarized the efforts within Snohomish County to reduce overdose deaths from opioids. While the county has seen a dramatic increase in overdose deaths in recent years. However, through the end of May, there has been a 20% decline in overdose deaths compared to the same period last year. Through May, there have been 106 opioid deaths, with a peak death toll of 31 deaths in February. At least one health department official attributes the decline of deaths to the county’s efforts to prevent opioid overdoses.

Some of those prevention efforts include:

 

·         Distribution of over 500 Narcan kits since 2022.

·         In April, the county began distribution of its $28.9 million in opioid settlement money to local recovery agencies. The focus of some of the agencies are,

o   Populations of minorities bear an over-representation of overdose deaths. Native Americans represent a rate of 73.3 per 100,000 residents for opioid overdose related visits to emergency rooms while blacks represent a rate of 44.3 per 100,00. Whites, which is the largest demographic in the county, visited the hospital at a rate of 15.4 per 100,000.

o   Overdose rates are disproportionately high in rural areas such as East Snohomish County. The county is working on a multicultural communications campaign that will include multicultural outreach teams and a peer support program. Ideal Option, a recovery clinic with a new downtown Monroe office has begun to offer free shuttle along Highway 2 from Index to Monroe for those who need transportation to appointments.

o   In July, the county will begin to collaborate with local outpatient clinics to develop better opioid and polysubstance use disorder practices.

o   In conjunction with the Washington State Health Care Authority, which is working with medical, treatment and social services to create Health Engagement Hubs; a series of one-stop clinics where people who uses drugs can access a range of medical, harm reduction, and social services, the county is helping the local harm reduction center, Sound Pathways, to apply for the Health Engagement Hub program.

 

 

As local governments apply the funds from the opioid settlements, they will have to use those funds on programs that truly reduce addiction to opioids. The challenge will be to stay away from feel good or punitive programs that are based on preconceived notions and to move those funds to programs that show evidence that they are effective in keeping people away from opioids.

 The following episodes of the Freakonomics Radio podcasts give good insights into the elements and challenges of treating people with OUD and are well worth listening to.

  

Freakonomics Radio:

https://freakonomics.com/podcast/why-has-the-opioid-crisis-lasted-so-long/

https://freakonomics.com/podcast/can-55-billion-end-the-opioid-epidemic/

https://freakonomics.com/podcast/the-opioid-tragedy-how-we-got-here/

 

Centers for Disease Control and Prevention:

https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

 

The Herald:

https://www.heraldnet.com/opinion/editorial-rep-larsen-outlines-to-do-list-for-opioid-crisis/

https://larsen.house.gov/uploadedfiles/rick_larsen_district_opioid_report_final.pdf

https://www.heraldnet.com/news/to-combat-fentanyl-snohomish-county-trickles-out-cash-to-recovery-groups/

https://www.heraldnet.com/news/as-deadly-overdoses-decline-snohomish-county-builds-on-whats-working/

https://www.heraldnet.com/news/drug-treatment-clinic-in-monroe-aims-to-reach-an-underserved-clientele/

For information on drugs and resources to find help with drug addiction check out this website from the Snohomish County Health Department,

Snohomish Overdose Prevention:

https://snohomishoverdoseprevention.com/

 

 

 

 

NALOXONE – Where to get this Life Saving Treatment

The U.S. Food and Drug Administration’s (FDA) approval to allow pharmacies to sell Naloxone (also known as Narcan) without a prescription encourages the distribution of this essential opioid treatment.

The state of Washington already has a program to encourage distribution of Naloxone. The state of Washington had a standing order to pharmacists to dispense Naloxone to anyone who might be at risk of an overdose or to family, friends, or others who are around people at risk of an opioid overdose.

Anyone can purchase Naloxone from a pharmacy without a prescription. The Washington State Department of Health (DOH) recommends calling ahead to ensure that the pharmacy has Naloxone in stock. DOH has a program for distribution of free Naloxone via mail order to people who cannot easily go to a community organization or a pharmacy. DOH also has a web page that can help you find naloxone from social service entities.

For more information about locating naloxone check out the following web sites,

 

Washington State Department of Health:

https://stopoverdose.org/find-naloxone-near-me-washington-state/

https://stopoverdose.org/

 

Snohomish Overdose Prevention:

https://snohomishoverdoseprevention.com/

 

Seattle Times:

https://www.seattletimes.com/seattle-news/health/what-to-know-about-narcan-the-overdose-reversal-drug-with-fda-approval/

DRUG UPDATE – Fentanyl Misconceptions

Over the last few months fentanyl has been receiving publicity in the local media. Reports of multi-colored “rainbow fentanyl” pills and blocks found in Oregon and Idaho. Concern being raised that rainbow fentanyl is targeting kids. Then the announcement of 17 suspects arrested throughout Washington and California with large amounts of meth, heroin, fentanyl, and cocaine. And the announcement by the Snohomish County Sheriff’s Office that the Snohomish Regional Drug Task Force confiscated $1.5 million in drugs in an Everett apartment that included 2,500 grams of pure fentanyl powder, over 100,000 M-30 fentanyl pills as well as cocaine, meth, and ethanol.

With all of this attention, facts about fentanyl can become hazy.

The University of Colorado Anschutz Medical Campus has identified some misinformation about fentanyl. It points out some facts about this dangerous drug.

·         Fentanyl is 50 time more potent than heroin.

·         Fentanyl is used in a medical setting to control pain; by injecting it in an operating room, with a patch for chronic pain or with a lollipop for severe pain.

·         Clandestine lab operators synthesize fentanyl using a couple of precursor molecules that they can get from China or Pakistan.

·         Since it takes so little to make it potent, fentanyl is easy to transport in small, difficult to detect batches. This contrasts with shipping opium poppies that are shipped in large bales or heroin in bricks.

The CU Anschutz Medical Campus points out that criminal manufacturers are substituting fentanyl for other drugs, not mixing the drugs together. The manufacturers will press tablets to look like oxycodone or Xanax.

Some other myths include,

·         If fentanyl is in the room and you inhale it, it will make you overdose or kill you. Fentanyl does not become a vapor.

·         Being near fentanyl causes serious effects. Some people report that after learning that fentanyl is in the room, they feel anxious, their heart rate increases, they experience a panic attack, or they feel like they are going to pass out. This is not a direct result of the fentanyl but due to anxiety about knowing that they are near fentanyl. This is called the “nocebo” effect, or when a patient has negative expectations about a treatment then any effects are more negative than normal. 

      CU Anschutz Medical Campus points out that the safest way to fill your prescription is from an accredited pharmacy. Purchasing prescription drugs outside of a pharmacy risks overdosing and potentially death. With a pharmacy, there are controls to ensure the dose and safety of the drugs that your doctor has prescribed for you. Purchasing the drugs on the black market such as on the street or on social media platforms like TikTok, Snapchat, or Instagram can endanger your life.

      Drugs most likely to be substituted by fentanyl include Xanax and oxycodone. Purchasing pills advertised as oxycodone on the street does not guarantee that the pills do not contain fentanyl. You can test the pills with a test kit, but there is not uniformity of the amount of fentanyl in each pill. You can test one pill and it might test with no fentanyl. Another pill might have a little bit. A third pill might have enough to kill you.

      A recent concern has been that rainbow fentanyl is intended to target kids. The press reported concerns that fentanyl could be included in Halloween candy. Several experts on drug addiction, illegal drug distribution, and Halloween myths have been quoted as skeptical of this concern. 

      Another argument is over the best way to reduce fentanyl deaths. Some insist tightening border security on the U.S.-Mexico border is the answer to choke off the supply. Others point out that fentanyl is easy to hide compared to other illegal drugs like heroin or opium. Many experts believe that only going after the supply will fail. That reducing demand through treatment and education will go farther in reducing fentanyl, in combination with interdicting the supply. 

      Congress set up the Commission on Combating Synthetic Opioid Trafficking in the National Defense Authorization Act for Fiscal Year 2020 to develop a strategic approach to reduce opioid overdose deaths. In its report issued in February 2022, it concludes, among other things:

·         The U.S. needs to improve its methods to disrupt the illegal drug supply coming into the U.S. through better targeting of drug sources, improved drug supply investigation methods and strengthened intelligence sharing and training.

·         The U.S. must make public health demand-reduction central to reducing opioid deaths by improving access to addiction treatment, researching improved treatment methods, and developing innovative drug prevention messaging to the public about the pervasiveness of synthetic opioids and the treatment resources available to those with opioid addictions.

 

 

The Seattle Times:

https://www.seattletimes.com/seattle-news/health/rainbow-fentanyl-found-in-or-id-but-not-wa/

https://www.seattletimes.com/seattle-news/health/as-fentanyl-drives-overdose-deaths-mistaken-beliefs-persist/

 

U.S. Department of Justice:

https://www.justice.gov/usao-wdwa/pr/eleven-people-arrested-washington-and-california-connection-cartel-connected-drug

 

The Herald:

https://www.heraldnet.com/news/police-eviction-at-everett-apartment-turns-up-1-5-million-in-drugs/

 

University of Colorado Anschutz Medical Campus:

https://news.cuanschutz.edu/news-stories/fentanyl-and-counterfeit-prescription-drugs-facts-and-myths

 

Commission on Combating Synthetic Opioid Trafficking:

https://www.rand.org/pubs/external_publications/EP68838.html

 

Snohomish Overdose Prevention:

https://snohomishoverdoseprevention.com/fentanyl/

 

Drug Enforcement Administration:

https://www.dea.gov/factsheets/fentanyl

 

EVERETT– National Drug Take Back Day

One of the strategies that law enforcement agencies and health professionals recommend to reduce addiction to opioids and other prescription drugs is to take back unused prescription drugs that you no longer need. To publicize this effort the Drug Enforcement Administration (DEA) sponsors National Prescription Drug Take Back Day. The next take back day is on Saturday, October 26.

The Everett Police Department is hosting a drug take back event on Saturday between 10am to 2pm at its North Precinct, 3002 Wetmore Ave, Everett, WA.

Can’t make it on Saturday? There are several locations that have return boxes where you can take your unneeded prescriptions. For more information go to:

https://med-project.org/locations/snohomish/



Everett Police Department:

https://www.facebook.com/EverettPoliceWA/photos/a.296828390366966/2455198747863242/?type=3&theater



DEA:

https://www.getsmartaboutdrugs.gov/content/national-take-back-day



And on a related note, finding ways to prevent addiction to opioids is a challenge for patients, doctors, law enforcement, and other professionals and citizens. The podcast, “Finding Fixes,” covers this issue for Snohomish County. It has started a new season recently.

The first episode for this season talks about preventing youth addiction. The second episode talks about treating acute pain to prevent opioid dependence.

The podcasts are well worth listening to on your podcast provider or at their website:

Finding Fixes:

https://www.getsmartaboutdrugs.gov/content/national-take-back-day

KING COUNTY– Fentanyl Update

The deaths of three high school students in King County due to fentanyl overdoses have caused local government officials to work to educate vulnerable populations about the dangers of fentanyl in counterfeit drugs.

In a post on its website, Seattle and King County Public Health gave a comprehensive report on fentanyl in King County and what people can do to avoid becoming victimized by it. While most of the publicity of fentanyl has come from King County, the dangers of this very powerful synthetic opioid is also present in Snohomish County. Parents should be sure to talk to their teenage children about its dangers and how to avoid becoming victimized.

Fentanyl has been found in both pill form and in powders, as depicted in the following graphic from Seattle and King County Public Health:

The report says, “… most overdose deaths are attributed to poly-substance use with methamphetamine-involved overdose deaths continuing to rise.” In 2018, there were 415 drug and alcohol deaths in King County, 77% of which involved multiple substances.   

The health district says that you can do something to curb this disturbing trend. It recommends the following:

Everyone should be aware of the risks associated with illicit drug use, and particularly the recent increase in fatal fentanyl overdoses:

·         Do not consume any pill that you do not directly receive from a pharmacy or your prescriber.

·         Pills purchased online are not safe.

·         Counterfeit pills purchased illicitly may contain fentanyl and appear to be legitimate pharmaceutical products, such as oxycodone pills.

Anyone can help prevent a fatal overdose:

·         Carry naloxone, the medication to reverse an opioid overdose.  Visit www.stopoverdose.org (http://stopoverdose.org/section/find-naloxone-near-you/) for locations that provide naloxone.

·         Do not use illicit substances alone.

·         Call 911 if you witness an opioid overdose. If you are trying to help in an overdose, the Washington State Good Samaritan law protects you and the overdose victim from drug possession charges.

·         Get rid of unused or expired medications. Find a dropbox near you: in King County- https://kingcountysecuremedicinereturn.org/.

·In Snohomish County-    https://snohomishoverdoseprevention.com/take-back-unwanted-meds/.

Treatment works:

·         Medication is available in the community that can cut
overdose risk in half and treat urges and cravings.

·         Call the 24-hour Recovery Help line: 1-866-789-1511 or visit www.warecoveryhelpline.org

Seattle & King County Public Health:

https://publichealthinsider.com/2019/09/26/overdose-update-recent-increase-in-overdose-deaths-linked-to-fentanyl-laced-pills-and-powders/?fbclid=IwAR3VjtazfN7_A02K2urY3KLaCbZ3acccQ4XrNBdOKqPFre3wSpPG1Ahb1Eg

KING COUNTY– Fentanyl Takes Lives of Teens

Teens have long experimented with drugs, be it alcohol, marijuana, and sometimes cocaine, ecstasy, or heroin and other opioids. The deaths of two teen boys in Sammamish and another from Ballard High School in Seattle points out the extreme dangers of the modern opioid epidemic.

Authorities say that the deaths were due to fentanyl overdoses. Detectives are investigating where the fentanyl came from. So far in 2019, seven teenagers in King County have died from fentanyl-related overdoses.

Fentanyl is a powerful synthetic opioid that works similarly to morphine and is 50 to 100 times more potent as morphine. It is prescribed by physicians to treat severe pain and is applied as a shot, in a patch that is put on the skin, or as a lozenge.

Most deaths from a fentanyl overdose come from illegally manufactured and distributed fentanyl. Some drug dealers mix fentanyl with other drugs, such as heroin, cocaine, methamphetamine and MDMA, to give the drug an extra and cheap “kick.” Drug dealers sell it in the form of a powder, drops on blotter paper, in eye droppers or made into pills that look like other prescription opioids. Local public health authorities say that fentanyl has been found in blue, white and pale green pills stamped with an “M” on one side and a “30” on the other side. Fentanyl pills have also been stamped with K9, 215 and √48.

Fentanyl’s effects can include extreme happiness, drowsiness, nausea, confusion, constipation, sedation, problems breathing, and unconsciousness. A Fentanyl overdose can slow or stop their breathing and can decrease the amount of oxygen in the brain leading to a coma, and permanent brain damage or death, like an opioid or heroin overdose. 

Given the potency of fentanyl, a tiny amount can be fatal.

The signs of an overdose include irregular sleep patterns, such as snoring when someone usually does not snore or difficulty in waking someone up. Other symptoms include cold, clammy skin, skin turning blue, coma, and respiratory failure.

Should someone have any of these symptoms, call 911 immediately. If available, apply Narcan. Stay with the patient until help arrives.

Fentanyl is serious business. Death due to an overdose can happen quickly.

Obviously, no parent wants their child to go through an experience like a fentanyl overdose. Educating your teenage child about illegal fentanyl should go a long way to help them avoid the pitfalls of this narcotic.



The Seattle Times:

https://www.seattletimes.com/seattle-news/crime/sammamish-officials-heartbroken-over-deaths-of-2-skyline-high-school-students-who-overdosed-on-fentanyl/



KOMO TV:

https://komonews.com/news/local/ballard-high-school-student-dies-from-accidental-fentanyl-overdose



Partnership for Drug-Free Kids:

https://drugfree.org/parent-blog/fentanyl-synthetic-opioids-5-things-need-know/



 National Institute on Drug Abuse:

https://www.drugabuse.gov/publications/drugfacts/fentanyl



Centers for Disease Control and Prevention:

https://www.cdc.gov/drugoverdose/opioids/fentanyl.html   

NATIONAL NIGHT OUT- Snohomish Overdose Prevention

This is the fourth in the series about organizations that offer help to the public that attended the National Night Out festivities at Willis Tucker Park on August 6, 2019.

As part of Snohomish County’s response to the county’s the opioid epidemic, the Snohomish Health District set up a web site to educate the public about opioids and heroin and provide a listing of treatment centers in Snohomish County.

The Health District gives talks to various groups about opioids/heroin and it gives naloxone (Narcan) training. It also works with the Snohomish County Multi-Agency Coordination Group which is the county’s organization that coordinates efforts to end the opioid epidemic. Other members of the group include South Snohomish County Fire and Rescue, Snohomish County Department of Emergency Management, Snohomish County Human Services, the Snohomish County Executive’s Office, the Snohomish County Sheriff’s Office and the Everett Police Department.

For more information about opioids, preventing addiction to them, and finding treatment to opioid addiction, go to,



Snohomish Overdose Prevention:

https://snohomishoverdoseprevention.com/



            On Facebook- https://www.facebook.com/NoOverdoseSnoCo/



UW Alcohol & Drug Abuse Institute:

http://stopoverdose.org/

SNOHOMISH OVERDOSE PREVENTION- 2018 Point in Time Survey

The Snohomish Health District has published a log of its second point in time opioid survey that it conducted in July 2018. In addition to giving numbers of opioid overdoses, deaths, etc. it gives a narrative of what county agencies are doing to prevent opioid addiction. It’s an interesting read.





Snohomish Overdose Prevention:

https://snohomishoverdoseprevention.com/point-in-time-epidemic/?fbclid=IwAR3GIL45vPcfc7Y9Y5uxGRuCYdrAW_0ZBCs5EF-WhWKZ7R4wEmUANIrg9qk

HUNTINGTON WEST VIRGINIA- Police Deploy Addiction Counselor

You probably have heard about the Snohomish County Sheriff’s Office’s Law Enforcement Embedded Social Worker program that embeds social workers with deputies who contact the homeless and offers drug addiction and mental health treatment. While Snohomish County is a leader in developing this type of approach to reducing drug addiction, other jurisdictions in the US are also adopting this new way of trying to reduce addiction.

Last night, CBS News’ 60 Minutes aired a segment on the police department in Huntington West Virginia which is using an addiction counselor on drug raids. The police department changed its approach when one day the town experienced 26 overdoses due to a batch of fentanyl laced heroin in just 4 hours.

Read the transcript of the segment below if you did not see last night’s episode of 60 minutes.



CBS News:

https://www.cbsnews.com/news/cops-bring-addiction-counselor-on-drug-raids-to-fight-opioid-crisis/

OPIOID CRISIS- Overdose Deaths from Fentanyl are Up

The Centers for Disease Control and Prevention (CDC) has released data showing a 70% increase in overdose deaths attributed to fentanyl during the first six months of this year in Washington State.

Fentanyl is a powerful synthetic opioid that is used by doctors to treat severe pain. Often applied as a patch to the skin, fentanyl is 30 to 50 times more powerful than heroin. A dose as small as 0.25 mg can kill.

In Snohomish County, in 2017, 23 people died from a fentanyl overdose. In 2018, preliminary figures show 34 people died from a fentanyl overdose, a 48% increase. In Washington State, in the first six months of 2018, 81 people died from fentanyl overdoses while during the same period in 2017 48 people died from fentanyl overdoses. That represents a 70% increase in fentanyl overdose deaths.

The Washington State Department of Health says that the overdoses are the result of taking illicit drugs. Illicit fentanyl has been found in counterfeit pills that look like prescription opioids. It has also been found in powders, colored white and other colors, that could be included in other illicit drugs such as heroin. The fact that this powerful drug could be included in other street drugs without the knowledge of the user shows how risky taking illicit drugs has become.

The Washington State Department of Health wants drug users to know this information so that they can take precautions. If you have someone in your family or a friend who uses heroin or illegal opioids, please pass this information to them. The Department of Health recommends,

·         Seek treatment. Health professionals have been recommending medication-assisted treatment options for those addicted to opioids. Opioid users can seek treatment from the Washington Recovery Help Line at (866) 789-1511 or online at http://www.warecoveryhelpline.org/.

·         Carry naloxone. For information on where you can find naloxone, go to http://stopoverdose.org/section/find-naloxone-near-you/.

·         If you witness an overdose, call 911, give naloxone and do rescue breathing. Fentanyl may require multiple doses of naloxone to restore breathing. The law (RCW 69.50.315) says neither the victim nor persons assisting with an overdose will be prosecuted for drug possession.

·         Never use drugs alone.

·         Be careful about using too fast. Fentanyl is fast-acting and deadly. Many experienced opioid users have overdosed or died by using too much, too quickly.

Washington State Department of Health:

https://www.doh.wa.gov/Newsroom/2018NewsReleases/18166OpioidOverdoseFentanylNewsRelease

The Seattle Times:

https://www.seattletimes.com/seattle-news/health/overdose-deaths-from-powerful-narcotic-fentanyl-on-the-rise-in-washington/

PRESCRIPTION OPIOIDS- How You Can Protect Yourself from Addiction

Opioids are highly addictive drugs. While they provide relief from pain especially after an accident or surgery, health and medical professionals have taken a second, more careful look at the use of opioids in reaction to the opioid crisis that has built up in the last few years.

While all people are not destined to become addicted to opioids, science cannot currently predict who is susceptible to opioid addiction. However, studies show how addictive opioids can be to an individual,

·         Nationally, 4 of every 5 new heroin addictions started with a person misusing prescription painkillers.

·         In Washington State, 57 percent of people currently using heroin were dependent on prescription opioids before they began using heroin.

Opioids bind themselves to a receptor in the brain blocking pain and increasing a sense of pleasure or euphoria. The problem with long term use of opioids is that the body builds up a tolerance to the drug, requiring more of the drug to work. Eventually there is no euphoria, but not using the drug makes the individual extremely sick, like the worst flu symptoms you have ever experienced. This is withdrawal. Withdrawal acts like a stone wall discouraging non-use of the drug.

And the risk of becoming addicted increases the longer you take the drug.

So, what can you do? If you and your doctor are planning major surgery consider the following,

·         Talk with your doctor about other methods to relieve pain such as over-the-counter pain relievers, physical therapy, exercise, or professional help coping with the emotional effects of pain.

·         If you do need opioids, your prescription should only be for a 3 to 7-day supply and you should take the lowest dose possible for the shortest period.

·         Securely store opioids away from kids and teens.

·         Safely dispose of any extra opioids that you do not need.

Local health officials are trying to educate the public to the benefits of opioids and to their dangers so that we as individuals can make more educated decisions when we are faced with surgeries or other situations that may cause pain.

For more about opioids, check out the following links.

Washington Health Alliance:

http://www.breecollaborative.org/wp-content/uploads/WHA-Bree-Opioid-Consumer-Fact-Sheet.pdf

Overdose Prevention Resource Guide:

http://snohomishoverdoseprevention.com/treatment-and-support/

Medical Education and Disposal Project:

https://med-project.org/locations/snohomish/

Snohomish Overdose Prevention:

http://snohomishoverdoseprevention.com/

The Herald:

https://www.heraldnet.com/marketplace/what-you-need-to-know-about-prescription-opioids/

OPIOID CRISIS- Finding Fixes

As Snohomish County works to control the heroin and opioid epidemic in the county, citizens may not understand just what it takes to find solutions to this problem.

Recently, InvestigateWest, a nonprofit journalism organization, began publishing a series of podcasts that document the county’s heroin/opioid prevention efforts under the title “Finding Fixes.” The podcasts tell the story of how the county is trying to work towards solutions from the viewpoints of the participants including the officials developing programs and the victims who are trying to control their addictions.

On Thursday November 8^th, Sno-Isle Libraries will be hosting a public meeting that it advertises as a local debut of the podcast under the title “Behind the Scenes of Finding Fixes.” At the meeting, citizens will be able to talk to the producers and hosts, Anna Boiko-Weyrauch and Kyle Norris, as well as local leaders, healthcare providers and community members who have been featured so far in the first 5 episodes of the podcast.

The event will be held on November 8^th from 6:30pm to 8pm at the Sno-Isle Service Center at 7312 35^th Ave NE, Marysville.

You can listen to the podcasts online at https://www.findingfixes.com/ or through your podcast provider.

Sno-Isle Libraries:

https://snohomishcountywa.gov/Archive.aspx?ADID=6088

ABANDONED HOMES- What to do with a Nuisance Property in your Neighborhood

Having a home that appears to have been abandoned is disconcerting for any neighborhood. The potential for decline with unused buildings and the potential for crime around those buildings brings fear to neighbors. Abandoned properties can attract squatters whose practices often accelerates the decline of the property. Drug use can occur along with disorderly conduct, prostitution, and burglary rings, using the property for storing stolen goods or as a chop shop for stolen vehicles or even stolen bikes.

For neighbors it can be frustrating to know what to do in these circumstances. Probably the best advice is to call 911 when you see suspicious activity.

The Snohomish County Sheriff’s Office has a “Nuisance Property Program” that has received publicity in social media and the local press. The Sheriff’s Office works with the Snohomish County Health District, Snohomish County code enforcement and human services to encourage landowners to clean up the properties and to remove the threat of decline and crime. Working with other parts of county government helps to ensure compliance with health and building codes and, where possible, to get help for squatters who may have drug addiction or mental health problems.

Often the challenge is to find who owns the property. The county needs an owner’s cooperation to declare squatters as trespassers. It obviously needs the owner to bring the property into compliance with local ordinances. It can be difficult to find someone who is responsible for the property, especially if it has going into foreclosure. Owners may be out of state, elderly, deceased, or even in prison or in the long-term care of a hospital or nursing home.

The Sheriff’s Office encourages all property owners to visit their properties to ensure it is secure and safe.

In most cases, property owners cooperate, especially when they receive notices from several county departments.

While the county does the heavy lifting, finding owners, notifying them, in some cases convincing them that they have a responsibility to comply with the law, neighbors may not see much improvement. Keeping an eye on the property and calling 911 when they see crime in progress or a life-threatening incident in progress, and calling the non-emergency number, (425) 407-3999, for any potential violations help the Sheriff’s Office and the other county agencies to know what is going on at the property.

You can also file a complaint with the health district for issues such as garbage being left on a property and with county code enforcement for violations of the county building code. See the links below for information on how to file a complaint.

Also, keep your own property safe by implementing practical burglary and car theft/car prowl prevention practices.

As Deputy Dave Chitwood puts it, “This is a process.” It may not go as fast as anyone likes, but persistence by the county and by the community at large will reduce the effects of abandoned properties.

The Herald:

https://www.heraldnet.com/news/no-one-likes-living-next-door-to-a-trashy-smelly-house/

Snohomish County Sheriff’s Office:

https://snohomishcountywa.gov/3948/The-Opioid-Crisis

Snohomish Health District:

https://snohomishonline.envisionconnect.com/#/home

Snohomish County Code Enforcement:

https://snohomishcountywa.gov/1152/Code-Enforcement

SNOHOMISH HEALTH DISTRICT- Expanding Needle Cleanup Program

The Snohomish Health District is expanding the number of locations that citizens can pick up needle clean-up kits starting on Wednesday. With the danger of needles left on the ground volunteer and neighborhood groups along with individuals have been working to pick up and safely dispose of the stray needles.

The health district has been providing free kits at its Everett headquarters. Beginning Wednesday, citizens can pick up kits at the Snohomish Health District Everett headquarters, the Everett and Lynnwood city halls and the Arlington and Monroe police departments.

The kits include a Sharps container (to hold syringes), puncture-proof gloves, safety glasses, tongs, hand sanitizer and instructions.

Once full, citizens can drop off Sharps containers at the Everett, Arlington and Mountlake Terrace recycling and transfer stations, the Monroe Police department or the health district.

The health district attempts to tackle the county’s opioid crisis from multiple angles including prevention, education and treatment. It also coordinates with several agencies and organizations. Distribution of the needle clean-up kits allows the public to be safely involved in helping to keep Snohomish County a clean and safe community.

Snohomish Overdose Prevention:

http://snohomishoverdoseprevention.com/clean-up/

The Herald:

http://www.heraldnet.com/news/needle-program-expanding-across-county/

OPIOIDS/HEROIN- A Guide for Parents to Help Their Children

Much of the publicity around the current Opioid/heroin crisis in Snohomish County has been focused on the homeless. However, teens or young adults, with good living conditions, can develop a dependency on opioids.

For these individuals, often the best source of help can come from their families. But, parents or siblings usually do not have the training or experience to help their children or brother or sister obtain help for their addiction.

The Partnership for Drug-Free Kids has developed a resource guide for parents to help them support their children who may have become involved with opioids. It also provides tips on ways to prevent children from becoming involved with drugs.

This thoughtful guide is worth reading, especially if your child may be in danger of becoming involved with opioids or heroin or if you suspect that they are already involved.

Some of its key points include:

1.      Have an on-going conversation with your teen or young adult about the risks of drugs.

2.      Seek non-opioids alternatives to manage your child’s pain.

3.      Monitor, secure and properly dispose of any prescription pain medications in your home.

4.      Know the sign of opioid misuse.

5.      Get an evaluation to determine your treatment options if your child is misusing opioids.

6.      Get and know how to use Naloxone (Narcan).

7.      Practice self-care including counseling for yourself and attending a support group.

This excellent guide goes into depth on all of the above recommendations. To download it, go to the following link,

Heroin, Fentanyl & Other Opioids:

https://drugfree.org/wp-content/uploads/2018/04/Heroin-Fentanyl-Other-Opioids-eBook-Partnership-for-Drug-Free-Kids.pdf?utm_source=email&utm_medium=parent&utm_campaign=opioid-ebook-release

The Partnership for Drug-Free Kids:

https://drugfree.org/

Snohomish Overdose Prevention:

http://snohomishoverdoseprevention.com/

Opioid Affected Families:

https://www.facebook.com/pg/opioidaffectedfamilies/posts/?ref=page_internal

http://www.heraldnet.com/news/new-support-group-for-those-whose-loved-ones-battle-opioids/

OPIOIDS- Getting the Right Help

The Federal Trade Commission (FTC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have jointly issued a warning about “miracle cures” or other treatments that promise fast results.

In a joint statement, they point out:

·         Dietary supplements have not been scientifically proven to ease withdrawal or treat opioid dependence.

·         Products such as Kratom are not proven treatments and can be addictive and dangerous.

There are no short cuts to addressing opioid dependence and withdrawal.

If you, a loved one or a friend need help with treating opioid dependence, go to this link for local treatment resources,

Snohomish Overdose Prevention:

http://snohomishoverdoseprevention.com/treatment-options/

A national resource that can help is sponsored by SAMHSA,

SAMHSA:

SAMHSA National Helpline: 1-800-662-HELP (4357)

SAMHSA confidential treatment locator: https://findtreatment.samhsa.gov/

FTC:

https://www.consumer.ftc.gov/articles/0223-getting-right-help-opioid-dependence-or-withdrawal

           

OPIOID CRISIS- Narcan Training on January 31

The Snohomish Health District, under its Snohomish Overdose Prevention program, will host Narcan (Naloxone) training at the Everett Public Library on January 31^st from 6pm to 7pm.

Narcan is an easily administered drug that blocks the effects of an opioid overdose.

Training will include how to administer Narcan, what makes opioids and opiates, how they affect the body, who is at risk of an overdose, what an opioid overdose looks like, and how you can obtain Narcan.

This training is for anyone. People who might be especially interested might include friends or family of people who are addicted to opioids or heroin. Knowing how to apply Narcan just might save a life.

Snohomish Overdose Prevention:

https://www.facebook.com/events/307478753096340/

FENTANYL- Fake Xanax Pills Reported with Fentanyl

Snohomish Overdose Prevention on Facebook is warning the public about counterfeit Xanax pills that the Snohomish Regional Drug and Gang Task Force reports seeing in Snohomish County.

 Fentanyl is an extremely potent opioid that can cause an overdose or death in small amounts.

Symptoms of a fentanyl overdose include pinpoint pupils, weak muscles, dizziness, confusion, extreme sleepiness, loss of consciousness, profoundly slowed heartbeat, very low blood pressure, dangerously slowed or stopped breathing, bluish tint to nails and lips.

If you discover someone who you suspect of a fentanyl overdose call 911 immediately. If naloxone is available, apply a dose. More than one dose may be needed to reverse the effects of fentanyl.

The Snohomish Regional Drug and Gang Task Force has been expecting fentanyl to show up in Snohomish County due to its presence in the rest of the U.S. and British Columbia. The task force’s observations demonstrates that fentanyl has arrived in the county.

Snohomish Overdose Prevention:

https://www.facebook.com/NoOverdoseSnoCo/

San Francisco Health Network:

http://www.sfhealthnetwork.org/for-immediate-release-opioid-overdoses-in-sf-caused-by-counterfeit-xanax-pill-containing-fentanyl/

National Institute on Drug Abuse:

https://www.drugabuse.gov/publications/drugfacts/fentanyl

Drugabuse.com:

https://drugabuse.com/library/fentanyl-overdose/#what-to-do-if-you-overdose-on-fentanyl

OPIOID CRISIS- Washington State’s Response Part 7

The Washington State Attorney General’s Office, Washington State Patrol and the Washington Association of Prosecuting Attorneys have issued a 29-page report with seven recommended goals to reduce illegal opioid use.

The seventh and final goal is to expand access to treatment. It recommends support and expanded statewide and local non-traditional law enforcement approaches, such as drug courts, Law Enforcement Assisted Diversion, and embedded social workers.

This goal looks at opioid addiction more as a disease than just a criminal justice problem. As a disease opioid addiction needs treatment. The report points out that there is a shortage of treatment services in Washington State for people entering and leaving the criminal justice system. It also says that there is a shortage in “aftercare” services such as connecting people in recovery to housing and employment.

It points to a 2016 U.S. Surgeon General report that “…nationally just ten percent of Americans facing drug addiction obtain treatment, in part due to limited availability and affordability of services.”

The report encourages continuation of drug courts to use treatment as an alternative to sentencing and supervision when possible. The principle of drug courts "is that treating participants' underlying substance abuse disorder can lower recidivism." Snohomish County has a Family Drug Treatment Court, an Adult Drug Treatment Court and a Juvenile Offender Drug Treatment Court.

Local law enforcement agencies can also help guide opioid addicts toward treatment. In King County the Law Enforcement Assisted Diversion (LEAD) program diverts people arrested for low-level, non-violent offenses, such as drug possession, minor property crimes, prostitution, etc., into drug treatment and support services instead of into the court system. In Snohomish County, the both the city of Everett and the Snohomish County Sheriff’s Office embeds social workers with police officers in its Everett Police Community Outreach and Enforcement Team and the Sheriff’s Office’s Office of Neighborhood’s Homeless Outreach team who find treatment for willing and qualifying homeless.

For the complete report, go to,

Washington State Attorney General’s Office:

http://agportal-s3bucket.s3.amazonaws.com/uploadedfiles/Another/News/Press_Releases/OpioidSummitReport.pdf

The first goal is to increase public awareness about the dangers of opioids (http://ssnoccrimewatch.blogspot.com/2017/11/opioid-crisis-washington-states-response.html).

The second goal is to prevent addiction by curtailing overprescribing (http://ssnoccrimewatch.blogspot.com/2017/11/opioid-crisis-washington-states.html).

The third goal is to reduce the illicit use of prescription opioids http://ssnoccrimewatch.blogspot.com/2017/11/opioid-crisis-washington-states_30.html.

The fourth goal is to disrupt and dismantle organizations responsible for trafficking narcotics  http://ssnoccrimewatch.blogspot.com/2017/12/opioid-crisis-washington-states.html

The fifth goal is to prevent further increases in overdose deaths from fentanyl

http://ssnoccrimewatch.blogspot.com/2017/12/opioid-crisis-washington-states_2.html

The sixth goal is to improve overdose reporting and information sharing http://ssnoccrimewatch.blogspot.com/2017/12/opioid-crisis-washington-states_3.html